Laserfiche WebLink
SAN JOAQUIN COUN . _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:{209) 468-3420 Fax:(209)464-0138 Web:www.sigov.or /c/ehd <br /> LI FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r C ( +i, Date: 12, is. / Y <br /> Address: �1 2 r f �; !a / ; A ' t( City: rQ C Zip Code: CIS 3'7 2 <br /> Owner/Operator: J t 1 Telephone: <br /> Program Element: Program Record: Inspection Type: PC <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS. -= <br /> 'i1 gar' 3- U ; Id-01112 0 { { F, ba ISO <br /> lea n <br /> Tte S; .Jji . an S a6h:n . 54 e re <br /> S c� inC) CieNnube., 4aiAtr, Ccfrecjrc�. <br /> ItemlLoCationi Temperature Item/Location , Temperature_ <br /> r� C ✓'�1.i f �'�GGr I' r�� - t' v �i l GAG: r 1 fir• / <br /> �u 13 Ic ✓- ;r <br /> L11 F <br /> Food Safety Certification i Facility Hot Water Temperature„I, r” h asking ;,, gip: <br /> �— <br /> Name: y ) Hand Sink: r �J i_ of �orine: qpmHeat: c,,n -/O� °FRA3- <br /> Exp.Date: 1 arewashing Sink: ,aof Quat.A m.: ther: of <br /> Received By/Title: / <br /> EH Specialist: Phone: <br /> Time in: Time Out: Y / Page, of Z <br /> I J <br /> EHD 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />